Abscess. A localized collection of pus buried in tissues, organs,
or confined spaces of the body, often accompanied by swelling and inflammation and
frequently caused by bacteria. The brain, lung, or kidney (for instance) could be
involved. See boil.
Addison’s disease. A disease characterized by severe weakness,
low blood pressure, and a bronzed coloration of the skin, due to decreased secretion of
cortisol from the adrenal gland. Dr. Thomas Addison (1793-1860), born near Newcastle,
England, described the disease in 1855. Synonyms: Morbus addisonii, bronzed skin disease.
Ague. Malarial or intermittent fever characterized by paroxysms
(stages of chills, fever, and sweating at regularly recurring times) and followed by an
interval or intermission whose length determines the epithets: quotidian, tertian,
quartan, and quintan ague (defined in the text). Popularly, the disease was known as
"fever and ague," "chill fever," "the shakes," and by names
expressive of the locality in which it was prevalent—such as, "swamp fever"
(in Louisiana), "Panama fever," and "Chagres fever."
Ague-cake. A form of enlargement of the spleen, resulting from the
action of malaria on the system.
Anasarca. Generalized massive dropsy. See dropsy.
Aphthae. See thrush.
Aphthous stomatitis. See canker.
Ascites. See dropsy.
Asthenia. See debility.
Bilious fever. A term loosely applied to certain enteric
(intestinal) and malarial fevers. See typhus.
Biliousness. A complex of symptoms comprising nausea, abdominal
discomfort, headache, and constipation—formerly attributed to excessive secretion of
bile from the liver.
Boil. An abscess of skin or painful, circumscribed inflammation of
the skin or a hair follicle, having a dead, pus-forming inner core, usually caused by a
staphylococcal infection. Synonym: furuncle.
Brain fever. See meningitis, typhus.
Bronchial asthma. A paroxysmal, often allergic disorder of
breathing, characterized by spasm of the bronchial tubes of the lungs, wheezing, and
difficulty in breathing air outward—often accompanied by coughing and a feeling of
tightness in the chest. In the nineteenth century the direct causes were thought to be
dust, vegetable irritants, chemical vapors, animal emanations, climatic influences, and
bronchial inflammation—all of which were reasonable guesses. The indirect causes were
thought to be transmissions by the nervous system or by the blood from gout, syphilis,
skin disease, renal disease, or heredity. Only the latter cause was a reasonable
assumption.
Camp fever. See typhus.
Cancer. A malignant and invasive growth or tumor (especially tissue
that covers a surface or lines a cavity), tending to recur after excision and to spread to
other sites. In the nineteenth century, physicians noted that cancerous tumors tended to
ulcerate, grew constantly, and progressed to a fatal end and that there was scarcely a
tissue they would not invade. Synonyms: malignant growth, carcinoma.
Cancrum otis. A severe, destructive, eroding ulcer of the cheek and
lip, rapidly proceeding to sloughing. In the last century it was seen in delicate,
ill-fed, ill-tended children between the ages of two and five. The disease was the result
of poor hygiene acting upon a debilitated system. It commonly followed one of the eruptive
fevers and was often fatal. The destructive disease could, in a few days, lead to gangrene
of the lips, cheeks, tonsils, palate, tongue, and even half the face; teeth would fall
from their sockets, and a horribly fetid saliva flowed from the parts. Synonyms: canker,
water canker, noma, gangrenous stomatitis, gangrenous ulceration of the mouth.
Canker. An ulcerous sore of the mouth and lips, not considered
fatal today. Synonym: aphthous stomatitis. See cancrum otis.
Carcinoma. See cancer.
Catarrh. Inflammation of a mucous membrane, especially of the air
passages of the head and throat, with a free discharge. It is characterized by cough,
thirst, lassitude, fever, watery eyes, and increased secretions of mucus from the air
passages. Bronchial catarrh was bronchitis; suffocative catarrh was croup; urethral
catarrh was gleet; vaginal catarrh was leukorrhea; epidemic catarrh was the same as
influenza. Synonyms: cold, coryza.
Childbirth. A cause given for many female deaths of the century.
Almost all babies were born in homes and usually were delivered by a family member or a
midwife; thus infection and lack of medical skill were often the actual causes of death.
Cholera. An acute, infectious disease, endemic in India and China
and now occasionally epidemic elsewhere—characterized by profuse diarrhea, vomiting,
and cramps. It is caused by a potent toxin discharged by the bacterium Vibrio cholerae,
which acts on the small intestine to cause secretion of large amounts of fluid. The
painless, watery diarrhea and the passing of rice-water stool are characteristic. Great
body-salt depletion occurs. Cholera is spread by feces-contaminated water and food. Major
epidemics struck the United States in the years 1832, 1849, and 1866. In the 1830s the
causes were generally thought to be intemperance in the use of ardent spirits or drinking
bad water; uncleanness, poor living or crowded and ill-ventilated dwellings; and too much
fatigue. By 1850 cholera was thought to be caused by putrid animal poison and miasma or
pestilential vapor rising from swamps and marshes—or that it entered the body through
the lungs or was transmitted through the medium of clothing. It was still believed that it
attacked the poor, the dissolute, the diseased, and the fearful—while the healthy,
well-clad, well-fed, and fearless man escaped the ravages of cholera.
Cholera infantum. A common, noncontagious diarrhea of young
children, occurring in summer or autumn. In the nineteenth century it was considered
indigenous to the United States; was prevalent during the hot weather in most of the towns
of the middle and southern states, as well as many western areas; and was characterized by
gastric pain, vomiting, purgation, fever, and prostration. It was common among the poor
and in hand-fed babies. Death frequently occurred in three to five days. Synonyms: summer
complaint, weaning brash, water gripes, choleric fever of children, cholera morbus.
Chorea. Any of several diseases of the nervous system,
characterized by jerky movements that appear to be well coordinated but are performed
involuntarily, chiefly of the face and extremities. Synonym: Saint Vitus’ dance.
Chronic. Persisting over a long period of time as opposed to acute
or sudden. This word was often the only one entered under "cause of death" in
the mortality schedules. The actual disease meant by the term is open to speculation.
Colic. Paroxysmal pain in the abdomen or bowels. Infantile colic is
benign paroxysmal abdominal pain during the first three months of life. Colic rarely
caused death; but in the last century a study reported that in cases of death,
intussusception (the prolapse of one part of the intestine into the lumen of an
immediately adjoining part) occasionally occurred. Renal colic can occur from disease in
the kidney, gallstone colic from a stone in the bile duct.
Congestion. An excessive or abnormal accumulation of blood or other
fluid in a body part or blood vessel. In congestive fever (see text), the internal organs
become gorged with blood.
Consumption. A wasting away of the body; formerly applied
especially to pulmonary tuberculosis. The disorder is now known to be an infectious
disease caused by the bacterial species Mycobacterium tuberculosis. Synonyms: marasmus (in
the mid-nineteenth century), phthisis.
Convulsions. Severe contortion of the body caused by violent,
involuntary muscular contractions of the extremities, trunk, and head. See epilepsy.
Coryza. See catarrh.
Croup. Any obstructive condition of the larynx (voice box) or
trachea (windpipe), characterized by a hoarse, barking cough and difficult breathing
occurring chiefly in infants and children. The obstruction could be caused by allergy, a
foreign body, infection, or new growth (tumor). In the early-nineteenth century it was
called cynanche trachealis. The crouping noise was similar to the sound emitted by a
chicken affected with the pip, which in some parts of Scotland was called roup; hence,
probably, the term croup. Synonyms: roup, hives, choak, stuffing, rising of the lights.
Debility. Abnormal bodily weakness or feebleness; decay of
strength. This was a term descriptive of a patient’s condition and of no help in
making a diagnosis. Synonym: asthenia.
Diphtheria. An acute infectious disease caused by toxigenic strains
of the bacillus Corynebacterium diphtheriae, acquired by contact with an infected person
or a carrier of the disease. It was usually confined to the upper respiratory tract
(throat) and characterized by the formation of a tough membrane (false membrane) attached
firmly to the underlying tissue that would bleed if forcibly removed. In the nineteenth
century the disease was occasionally confused with scarlet fever and croup.
Dropsy. A contraction for hydropsy. Edema, the presence of
abnormally large amounts of fluid in intercellular tissue spaces or body cavities.
Abdominal dropsy is ascites; brain dropsy is hydrocephalus; and chest dropsy is
hydrothorax. Cardiac dropsy is a symptom of disease of the heart and arises from
obstruction to the current of blood through the heart, lungs, or liver. Anasarca is
general fluid accumulation throughout the body.
Dysentery. A term given to a number of disorders marked by
inflammation of the intestines (especially of the colon) and attended by pain in the
abdomen, by tenesmus (straining to defecate without the ability to do so), and by frequent
stools containing blood and mucus. The causative agent may be chemical irritants,
bacteria, protozoa, or parasitic worms. There are two specific varieties: (1) amebic
dysentery caused by the protozoan Entamoeba histolytica; (2) bacillary dysentery caused by
bacteria of the genus Shigella. Dysentery was one of the most severe scourges of armies in
the nineteenth century. The several forms of dysentery and diarrhea accounted for more
than one-fourth of all the cases of disease reported during the first two years of the
Civil War. Synonyms: flux, bloody flux, contagious pyrexia (fever), frequent griping
stools.
Eclampsia. A form of toxemia (toxins—or poisons—in the
blood) accompanying pregnancy, characterized by albuminuria (protein in the urine), by
hypertension (high blood pressure), and by convulsions. In the last century, the term was
used for any form of convulsion. Edema. See dropsy.
Effluvia. Exhalations or emanations, applied especially to those of
noxious character. In the mid-nineteenth century, they were called "vapours" and
distinguished into the contagious effluvia, such as rubeolar (measles); marsh effluvia,
such as miasmata; and those arising from animals or vegetables, such as odors.
Emphysema, pulmonary. A chronic, irreversible disease of the lungs,
characterized by abnormal enlargement of air spaces in the lungs and accompanied by
destruction of the tissue lining the walls of the air sacs. By 1900 the condition was
recognized as a chronic disease of the lungs associated with marked dyspnea (shortness of
breath), hacking cough, defective aeration (oxygenation) of the blood, cyanosis (blue
color of facial skin), and a full and rounded or "barrel-shaped" chest. This
disease is now most commonly associated with tobacco smoking.
Enteric fever. See typhoid fever.
Epilepsy. A disorder of the nervous system, characterized either by
mild, episodic loss of attention or sleepiness (petittnal) or by severe convulsions with
loss of consciousness (grand mal). Synonyms: falling sickness, fits.
Erysipelas. An acute, febrile, infectious disease, caused by a
specific group ~4 streptococcus bacterium and characterized by a diffusely spreading,
deep-red inflammation of the skin or mucous membranes causing a rash with a well-defined
margin. Synonyms: Rose, Saint Anthony’s Fire (from its burning heat or, perhaps,
because Saint Anthony was supposed to cure it miraculously).
Flux. See dysentery.
Furuncle. See boil.
Gangrene. Death and decay of tissue in a part of the
body—usually a limb—due to injury, disease, or failure of blood supply. Synonym:
mortification.
Gleet. See catarrh.
Gravel. A disease characterized by multiple small calculi (stones
or concretions of mineral salts) which are formed in the kidneys, passed along the ureters
to the bladder, and expelled with the urine. Synonym: kidney stone.
Hectic fever. A daily recurring fever with profound sweating,
chills, and flushed appearance—often associated with pulmonary tuberculosis or septic
poisoning.
Hives. A skin eruption of wheals (smooth, slightly elevated areas
on the skin) which is redder or paler than the surrounding skin. Often attended by severe
itching, it usually changes its size or shape or disappears within a few hours. It is the
dermal evidence of allergy. See the discussion under croup; also called cynanche
trachealis. In the mid-nineteenth century, hives was a commonly given cause of death of
children three years and under. Because true hives does not kill, croup was probably the
actual cause of death in those children.
Hospital fever. See typhus.
Hydrocephalus. See dropsy.
Hydrothorax. See dropsy.
Icterus. See jaundice.
Inanition. Exhaustion from lack of nourishment; starvation. A
condition characterized by marked weakness, extreme weight loss, and a decrease in
metabolism resulting from severe and prolonged (usually weeks to months) insufficiency of
food.
Infection. The affection or contamination of a person, organ, or
wound with invading, multiplying, disease-producing germs—such as bacteria,
rickettsiae, viruses, molds, yeasts, and protozoa. In the early part of the last century,
infections were thought to be the propagation of disease by effluvia (see above) from
patients crowded together. "Miasms" were believed to be substances which could
not be seen in any form—emanations not apparent to the senses. Such miasms were
understood to act by infection.
Inflammation. Redness, swelling, pain, tenderness, heat, and
disturbed function of an area of the body, especially as a reaction of tissue to injurious
agents. This mechanism serves as a localized and protective response to injury. The word
ending -itis denotes inflammation on the part indicated by the word stem to which it is
attached—that is, appendicitis, pleuritis, etc. Microscopically, it involves a
complex series of events, including enlargement of the sizes of blood vessels; discharge
of fluids, including plasma proteins; and migration of leukocytes (white blood cells) into
the inflammatory focus. In the last century, cause of death often was listed as
inflammation of a body organ—such as, brain or lung—but this was purely a
descriptive term and is not helpful in identifying the actual underlying disease.
Intussusception. The slipping of one part within another, as the
prolapse of one part of the intestine into the lumen of an immediately adjoining part.
This leads to obstruction and often must be relieved by surgery. Synonym: introsusception.
Jail fever. See typhus.
Jaundice. Yellow discoloration of the skin, whites of the eyes, and
mucous membranes, due to an increase of bile pigments in the blood—often symptomatic
of certain diseases, such as hepatitis, obstruction of the bile duct, or cancer of the
liver. Synonym: icterus.
Kidney stone. See gravel.
Kings evil. A popular name for scrofula. The name originated in the
time of Edward the Confessor, with the belief that the disease could be cured by the touch
of the king of England.
Lockjaw. Tetanus, a disease in which the jaws become firmly locked
together. Synonyms: trismus, tetanus.
Malignant fever. See typhus.
Marasmus. Malnutrition occurring in infants and young children,
caused by an insufficient intake of calories or protein and characterized by thinness, dry
skin, poor muscle development, and irritability. In the mid-nineteenth century, specific
causes were associated with specific ages: In infants under twelve months old, the causes
were believed to be unsuitable food, chronic vomiting, chronic diarrhea, and inherited
syphilis. Between one and three years, marasmus was associated with rickets or cancer.
After the age of three years, caseous (cheeselike) enlargement of the mesenteric glands
(located in the peritoneal fold attaching the small intestine to the body wall) became a
given cause of wasting. (See tabes mesenterica.) After the sixth year, chronic pulmonary
tuberculosis appeared to be the major cause. Marasmus is now considered to be related to
kwashiorkor, a severe protein deficiency.
Meningitis. Inflammation of the meninges (the three membranes
covering the brain and spinal cord), especially of the pia mater and arachnoid—caused
by a bacterial or viral infection and characterized high fever, severe headache, and stiff
neck or back muscles. Synonym: brain fever.
Morbus. Latin word for disease. In the last century, when applied
to a particular disease, morbus was associated with some qualifying adjective or noun,
indicating the nature or seat of such disease. Examples: morbus cordis, heart disease;
morbus caducus, epilepsy or failing sickness.
Neuralgia. Sharp and paroxysmal pain along the course of a sensory
nerve. There are many causes: anemia, diabetes, gout, malaria, syphilis. Many varieties of
neuralgia are distinguished according to the part affected—such as face, arm, leg.
Paristhmitis. See quinsy.
Petechial fever. See typhus.
Phthisis. See consumption.
Pleurisy. Inflammation of the pleura, the membranous sac lining the
chest cavity, with or without fluid collected in the pleural cavity. Symptoms are chills,
fever, dry cough, and pain in the affected side (a stitch).
Pneumonia. Inflammation of the lungs with congestion or
consolidation---caused by viruses, bacteria, or physical and chemical agents.
Pus. A yellow-white, more or less viscid substance found in
abscesses and sores, consisting of a liquid plasma in which white blood cells are formed
and suspended by the process of inflammation.
Putrid fever. See typhus.
Putrid sore throat. Ulceration of an acute form, attacking the
tonsils and rapidly running into sloughing of the fauces (the cavity at the back of the
mouth, leading to the pharynx).
Pyrexia. See dysentery.
Quinsy. A fever, or a febrile condition. An acute inflammation of
the tonsils, often leading to an abscess; peritonsillar abscess. Synonyms: suppurative
tonsillitis, cynanche tonsillaris, paristhmitis, sore throat.
Scarlatina. Scarlet fever. A contagious febrile disease,
caused by infection with the bacteria group. A beta-hemolytic streptococci (which
elaborate a toxin with an affinity for red blood cells) and characterized by a scarlet
eruption, tonsillitis, and pharyngitis.
Scrofula. Primary tuberculosis of the lymphatic glands, especially
those in the neck. A disease of children and young adults, it represents a direct
extension of tuberculosis into the skin from underlying lymph nodes. It evolves into cold
abscesses, multiple skin ulcers, and draining sinus tracts. Synonym: king’s evil.
Septic. Infected, a condition of local or generalized invasion of
the body by disease-causing microorganisms (germs) or their toxins.
Ship fever. See typhus.
Spotted fever. See typhus.
Suffocation. The stoppage of respiration. In the nineteenth
century, suffocation was reported as being accidental or homicidal. The accidents could be
by the impaction of pieces of food or other obstacles in the pharynx or by the entry of
foreign bodies into the larynx (as a seed, coin, or food). Suffocation of newborn children
by smothering under bedclothes may have happened from carelessness as well as from intent.
However, the deaths also could have been due to SIDS (sudden infant death syndrome),
wherein the sudden and unexpected death of an apparently healthy infant, while asleep,
typically occurs between the ages of three weeks and five months and is not explained by
careful postmortem studies. Synonyms of SIDS: crib death and cot death. It was felt that
victims of homicidal suffocation were chiefly infants or feeble and infirm persons.
Summer complaint. See cholera infantum.
Suppuration. The production of pus.
Tabes mesenterica. Tuberculosis of the mesenteric glands in
children, resulting in digestive derangement and wasting of the body.
Teething. The entire process which results in the eruption of the
teeth. Nineteenth-century medical reports stated that infants were more prone to disease
at the time of teething. Symptoms were restlessness, fretfulness, convulsions, diarrhea,
and painful and swollen gums. The latter could be relieved by lancing over the protruding
tooth. Often teething was reported as a cause of death in infants. Perhaps they became
susceptible to infections, especially if lancing was performed without antisepsis. Another
explanation of teething as a cause of death is that infants were often weaned at the time
of teething; perhaps they then died from drinking contaminated milk, leading to an
infection, or from malnutrition if watered-down milk was given.
Tetanus. An infectious, often-fatal disease caused by a specific
bacterium, Clostridium tetani, that enters the body through wounds; characterized by
respiratory paralysis and tonic spasms and rigidity of the voluntary muscles, especially
those of the neck and lower jaw. Synonyms: trismus, lockjaw.
Thrush. A disease characterized by whitish spots and ulcers on the
membranes of the mouth, tongue, and fauces caused by a parasitic fungus, Candida albicans.
Thrush usually affects sick, weak infants and elderly individuals in poor health. Now it
is a common complication from excessive use of broad-spectrum antibiotics or cortisone
treatment. Synonyms: aphthae, sore mouth, aphthous stomatitis.
Trismus nascentium or neonatorum. A form of tetanus seen only in
infants, almost invariably in the first five days of life, probably due to infection of
the umbilical stump.
Typhoid fever An infectious, often-fatal, febrile disease,
usually occurring in the summer months—characterized by intestinal inflammation and
ulceration caused by the bacterium Salmonella typhi, which is usually introduced by food
or drink. Symptoms include prolonged hectic fever, malaise, transient characteristic skin
rash (rose spots), abdominal pain, enlarged spleen, slowness of heart rate, delirium, and
low white-blood cell count. The name came from the disease’s similarity to typhus
(see below). Synonym: enteric fever.
Typhus. An acute, infectious disease caused by several
micro-organism species of Rickettsia (transmitted by lice and fleas) and characterized by
acute prostration, high fever, depression, delirium, headache, and a peculiar eruption of
reddish spots on the body. The epidemic or classic form is louse borne; the endemic or
murine is flea borne. Synonyms: typhus fever, malignant fever (in the 1850s), jail fever,
hospital fever, ship fever, putrid fever, brain fever, bilious fever, spotted fever,
petechial fever, camp fever.
Virus. An ultramicroscopic, metabolically inert infectious agent
that replicates only within the cells of living hosts, mainly bacteria, plants, and
animals. In the early 1800s virus meant poison, venom, or contagion.
Yellow fever. An acute, often-fatal, infectious febrile disease of
warm climates—caused by a virus transmitted by mosquitoes, especially Aledes aegypti,
and characterized by liver damage and jaundice, fever, and protein in the urine. In 1900
Walter Reed and others in Panama found that mosquitoes transmit the disease. Clinicians
in. the late nineteenth century recognized "specific yellow fever" as being
different from "malarious yellow fever." The latter supposedly was a form of
malaria with liver involvement but without urine involvement.
NOTES AND REFERENCES
William Cullen, First Lines of the Practice of Physic with Practical
and Explanatory Notes by John Rotheram (New York: Evert Duyckinck, 1801 J. Harper, 1826);
Marshall Hail, The Principles of Diagnosis (New York:
D. Appleton Robley Dunglison, A Dictionary of Medical
Science, Containing a Concise Account of the Various Subjects and Terms
(Philadelphia: Lea and Blanchard, 1844); Richard D. Hoblyn, A Dictionary of Terms Used in
Medicine and the Collateral Sciences (Philadelphia: Henry C. Lea, 1865); William Aitken,
The Science and 1872); Richard Quain, ed., A Dictionary of Medicine (New York: D. Appleton
and Company, 1883); Austin Flint, A Treatise on the Principles 1884); George M. Gould, An
Illustrated Dictionary of Medicine, Biology, and Allied Sciences (Philadelphia: P.
Blakiston’s Son Glentworth Reeve Butler, The Diagnostics of Internal Medicine (New
York and London: D. Appleton and Company, 1903); The Random House Dictionary of the
English Language, 2d ed., unabridged (New York: Random House, 1987); Dorland’s
Illustrated Medical Dictionary (Philadelphia: W.B. Saunders Co., 1988).
From the article "Disease and Death in the Nineteenth Century: A
Genealogical Perspective", by James Byars Carter, M.D. Exerpted from a complete
article on the subject from The National Genealogical Society Quarterly, Vol. 76, (Dec
1988) pp 289-301.
